Provider Demographics
NPI:1841781838
Name:ELIZABETH PHYSICAL THERAPY & ELIZABETH FOOT AND ANKLE ASSOCIATION
Entity Type:Organization
Organization Name:ELIZABETH PHYSICAL THERAPY & ELIZABETH FOOT AND ANKLE ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTZIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-300-5456
Mailing Address - Street 1:240 WILLIAMSON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-3671
Mailing Address - Country:US
Mailing Address - Phone:908-300-5456
Mailing Address - Fax:908-655-9832
Practice Address - Street 1:240 WILLIAMSON ST STE 200
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-3671
Practice Address - Country:US
Practice Address - Phone:908-300-5456
Practice Address - Fax:908-655-9832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty